Exercise programmes to prevent falls among older adults: modelling health gain, cost-utility and equity impacts

Deverall, Eamonn; Kvizhinadze, Giorgi; Pega, Frank; Blakely, Tony; Wilson, Nick

doi:10.1136/injuryprev-2016-042309

Cited by 15 publications

(55 citation statements)

References 26 publications

(36 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Compared with the cost-effectiveness of other interventions to prevent falls in the same population, first-eye expedited cataract surgery compares favourably. Other New Zealand studies using the same fundamental model have reported the cost per QALY for strength and balance exercise programmes (US$4600)16 and home safety modifications (NZ$6000)18 to be comparable.…”

Section: Discussionmentioning

confidence: 81%

“…*That is for injurious falls coming to medical attention (primary care visit or hospitalisation) as per our established falls prevention model 18DR, discount rate; ICER, incremental cost-effectiveness ratio; QALY, quality-adjusted life year.…”

Section: Resultsmentioning

confidence: 99%

“…*That is for injurious falls coming to medical attention (primary care visit or hospitalisation) as per our established falls prevention model 18…”

Section: Resultsmentioning

confidence: 99%

“…These are detailed in table 1 and further described in the text below. All other aspects of the model relating to the epidemiology and costs of falls were as per the previously published work using the same core macrosimulation model built in TreeAge 16–18…”

Section: Methodsmentioning

confidence: 99%

“…New Zealand is a country where there is substantial health sector interest in falls prevention (eg, work by the Health Quality and Safety Commission in hospitals,15 and also by the national agency tasked with injury prevention: the Accident Compensation Corporation14). New Zealand researchers have also reported that various falls prevention interventions are cost-effective in this country, for example, for home safety assessment and modification16 17 and exercise programmes 18…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Cataract surgery for falls prevention and improving vision: modelling the health gain, health system costs and cost-effectiveness in a high-income country

Boyd¹,

Kvizhinadze

Kho³

et al. 2019

Inj Prev

Self Cite

View full text Add to dashboard Cite

AimTo estimate the health gain, health system costs and cost-effectiveness of cataract surgery when expedited as a falls prevention strategy (reducing the waiting time for surgery by 12 months) and as a routine procedure.MethodsAn established injurious falls model designed for the New Zealand (NZ) population (aged 65+ years) was adapted. Key parameters relating to cataracts were sourced from the literature and the NZ Ministry of Health. A health system perspective with discounting at 3% was used.ResultsExpedited cataract surgery for 1 year of incident cases was found to generate a total 240 quality-adjusted life years (QALYs) (95% uncertainty interval (UI) 161 to 360) at net health system costs of NZ$2.43 million (95% UI 2.02 to 2.82 million) over the remaining lifetimes of the surgery group. This intervention was cost-effective by widely accepted standards with an incremental cost-effectiveness ratio (ICER) of NZ$10 600 (US$7540) (95% UI NZ$6030 to NZ$15 700) per QALY gained. The level of cost-effectiveness did not vary greatly by sex, ethnicity and previous fall history, but was higher for the 65–69 age group compared with the oldest age group of 85–89 years (NZ$7000 vs NZ$14 200 per QALY gained). Comparing cataract surgery with no surgery, the ICER was even more favourable at NZ$4380 (95% UI 2410 to 7210) per QALY. Considering only the benefits for vision improvement and excluding the benefits of falls prevention, it was still favourable at NZ$9870 per QALY.ConclusionsExpedited cataract surgery appears very cost-effective. Routine cataract surgery is itself very cost-effective, and its value appears largely driven by the falls prevention benefits.

show abstract

Section: Discussionmentioning

confidence: 81%

Section: Resultsmentioning

confidence: 99%

“…*That is for injurious falls coming to medical attention (primary care visit or hospitalisation) as per our established falls prevention model 18…”

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Cataract surgery for falls prevention and improving vision: modelling the health gain, health system costs and cost-effectiveness in a high-income country

Boyd¹,

Kvizhinadze

Kho³

et al. 2019

Inj Prev

Self Cite

View full text Add to dashboard Cite

show abstract

F3ALLS Approach to Preventing Falls

Morley

2018

The Journal of nutrition, health and aging

View full text Add to dashboard Cite

Examining Equity Effects of Health Interventions in Cost-Effectiveness Analysis: A Systematic Review

Avanceña

Prosser²

2021

Value in Health

View full text Add to dashboard Cite

This systematic review aims to catalogue and describe published applications of equity-informative costeffectiveness analysis (CEAs).Methods: Following PRISMA guidelines, we searched Medline for English-language, peer-reviewed CEAs published on or before August 2019. We included CEAs that evaluated 2 or more alternatives; explicitly mentioned equity as a consideration or decision-making principle; and applied an equity-informative CEA method to analyze or examine at least 1 equity criterion in an applied CEA. We extracted data on selected characteristics and analyzed reporting quality using the CHEERS checklist.Results: Fifty-four articles identified through a search and bibliography reviews met the inclusion criteria. All articles were published on or after 2010, with 80% published after 2015. Most studies evaluated primary prevention interventions in disease areas such as cancer, infectious diseases, and cardiovascular disease. Equity impact analysis alone was the most common equityinformative CEA (56%), followed by equity impact analysis with financial protection effects (30%). At least 11 different equity criteria have been used in equity-informative CEAs; socioeconomic status and race/ethnicity were used most frequently. Seventy-eight percent of studies reported finding "greater value" in an intervention after examining its distributional effects. Conclusion:The number of equity-informative CEAs is increasing, and the wide range of equity criteria, diseases, interventions, settings, and populations represented suggests that broad application of these methods is feasible but will require further refinement. Inclusion of equity into CEAs may shift the value of evaluated interventions and can provide crucial additional information for decision makers.

show abstract

Exercise programmes to prevent falls among older adults: modelling health gain, cost-utility and equity impacts

Abstract: Implementing any of these three types of exercise programme for falls prevention in older people could produce considerable health gain, but with the home-based version being likely to be the most cost-effective.

Cited by 15 publications

References 26 publications

Cataract surgery for falls prevention and improving vision: modelling the health gain, health system costs and cost-effectiveness in a high-income country

Cataract surgery for falls prevention and improving vision: modelling the health gain, health system costs and cost-effectiveness in a high-income country

F3ALLS Approach to Preventing Falls

Examining Equity Effects of Health Interventions in Cost-Effectiveness Analysis: A Systematic Review

Contact Info

Product

Resources

About